Abstract：
BACKGROUND: Subcutaneous immunotherapy (SCIT) is the oldest and an efficient immunotherapy method that has been used for the treatment of allergic diseases. Systemic adverse effects (SAEs) may occur during the SCIT. For this reason, there may be problems in the continuing treatment. In this study, we primarily aimed to determine the frequency of SAEs, the risk factors that may be associated with SAEs, and clinical and laboratory parameters that can predict systemic reactions in the patients who underwent SCIT. Second, we aimed to evaluate the reasons for discontinuing SCIT and the conditions special to Turkey.
METHODS: The files of 295 patients who had received SCIT were evaluated retrospectively.
RESULTS: SCIT was administered against house dust mites (HDM) in almost all patients (n: 291, 98.6%). A total of 14,357 injections were administered to 295 patients included in the study, and 47.8% (n: 141) of the patients discontinued treatment. The most common reason for discontinuing treatment was the supply problem in Turkey for immunotherapy preparations (n: 70, 49.6%). The second reason was that the injection visits were not continued regularly, even though there were no adverse effects related to the treatment (n: 44, 31.2%). SAEs were observed in 16.6% of the patients and 0.66% of the injections. SAEs were more frequent in girls, in asthmatic patients, and in moderate asthmatic patients (p = 0.005, p = 0.016, p = 0.043, respectively). Treatment was terminated in 13 patients (4.4%) due to SAEs. The most common SAE was bronchoconstriction (n: 40, 85.1%). None of our patients developed hypotension or loss of consciousness. Median blood eosinophil count and basophil count and the skin prick test diameter for Dermatophagoides farinae were observed to be significantly higher in the group with SAE (p = 0.024, p = 0.034, p = 0.045, respectively).
CONCLUSIONS: Although SAE may develop in pediatric patients undergoing HDM-specific SCIT, severe reactions are rare. Girls, asthmatic patients, especially moderate asthmatic patients, and patients with high blood eosinophil and basophil levels should be monitored more carefully for the development of SAE.
METHODS: The files of 295 patients who had received SCIT were evaluated retrospectively.
RESULTS: SCIT was administered against house dust mites (HDM) in almost all patients (n: 291, 98.6%). A total of 14,357 injections were administered to 295 patients included in the study, and 47.8% (n: 141) of the patients discontinued treatment. The most common reason for discontinuing treatment was the supply problem in Turkey for immunotherapy preparations (n: 70, 49.6%). The second reason was that the injection visits were not continued regularly, even though there were no adverse effects related to the treatment (n: 44, 31.2%). SAEs were observed in 16.6% of the patients and 0.66% of the injections. SAEs were more frequent in girls, in asthmatic patients, and in moderate asthmatic patients (p = 0.005, p = 0.016, p = 0.043, respectively). Treatment was terminated in 13 patients (4.4%) due to SAEs. The most common SAE was bronchoconstriction (n: 40, 85.1%). None of our patients developed hypotension or loss of consciousness. Median blood eosinophil count and basophil count and the skin prick test diameter for Dermatophagoides farinae were observed to be significantly higher in the group with SAE (p = 0.024, p = 0.034, p = 0.045, respectively).
CONCLUSIONS: Although SAE may develop in pediatric patients undergoing HDM-specific SCIT, severe reactions are rare. Girls, asthmatic patients, especially moderate asthmatic patients, and patients with high blood eosinophil and basophil levels should be monitored more carefully for the development of SAE.
摘要：
背景：皮下免疫疗法（SCIT）是最古老且有效的免疫治疗方法，已用于治疗过敏性疾病。在SCIT期间可能发生系统性不良反应(SAE)。出于这个原因,继续治疗可能会有问题。在这项研究中,我们的主要目的是确定SAE的频率，可能与SAE相关的风险因素，以及可以预测接受SCIT的患者的全身反应的临床和实验室参数。第二,我们旨在评估终止SCIT的原因以及土耳其的特殊条件。
方法：对295例接受SCIT的患者进行回顾性评估。
结果：在几乎所有患者（n：291，98.6％）中，对室内尘螨（HDM）进行了SCIT治疗。共对295名纳入研究的患者进行了14,357次注射，47.8%(n:141)的患者停止治疗。停止治疗的最常见原因是土耳其免疫疗法制剂的供应问题（n：70，49.6％）。第二个原因是注射访问没有定期进行，即使没有与治疗相关的不良反应（n：44，31.2％）。在16.6%的患者和0.66%的注射中观察到SAE。SAE在女孩中更常见，在哮喘患者中，和中度哮喘患者（分别为p=0.005，p=0.016，p=0.043）。13例患者（4.4%）因SAE终止治疗。最常见的SAE是支气管收缩(n:40,85.1%)。我们的患者没有出现低血压或意识丧失。在SAE组中，观察到粉尘螨的血嗜酸性粒细胞计数和嗜碱性粒细胞计数中位数以及皮肤点刺试验直径显着升高（分别为p=0.024，p=0.034，p=0.045）。
结论：虽然SAE可能发生在接受HDM特异性SCIT的儿科患者中，严重的反应是罕见的。女孩们,哮喘患者,尤其是中度哮喘患者，对于高嗜酸性粒细胞和嗜碱性粒细胞水平的患者，应更仔细地监测SAE的发展。
方法：对295例接受SCIT的患者进行回顾性评估。
结果：在几乎所有患者（n：291，98.6％）中，对室内尘螨（HDM）进行了SCIT治疗。共对295名纳入研究的患者进行了14,357次注射，47.8%(n:141)的患者停止治疗。停止治疗的最常见原因是土耳其免疫疗法制剂的供应问题（n：70，49.6％）。第二个原因是注射访问没有定期进行，即使没有与治疗相关的不良反应（n：44，31.2％）。在16.6%的患者和0.66%的注射中观察到SAE。SAE在女孩中更常见，在哮喘患者中，和中度哮喘患者（分别为p=0.005，p=0.016，p=0.043）。13例患者（4.4%）因SAE终止治疗。最常见的SAE是支气管收缩(n:40,85.1%)。我们的患者没有出现低血压或意识丧失。在SAE组中，观察到粉尘螨的血嗜酸性粒细胞计数和嗜碱性粒细胞计数中位数以及皮肤点刺试验直径显着升高（分别为p=0.024，p=0.034，p=0.045）。
结论：虽然SAE可能发生在接受HDM特异性SCIT的儿科患者中，严重的反应是罕见的。女孩们,哮喘患者,尤其是中度哮喘患者，对于高嗜酸性粒细胞和嗜碱性粒细胞水平的患者，应更仔细地监测SAE的发展。
